Effects of inspiratory muscle training on functionality in chronic obstructive pulmonary disease: A systematic review

Abstract

Introduction: Chronic obstructive pulmonary disease presents with persistent airflow limitation, reduced functional capacity, exercise intolerance, dyspnea, and impaired quality of life. Inspiratory muscle training is a non-pharmacological strategy to strengthen respiratory muscles and improve functional performance. Objective: To analyze the effects of this training on functional capacity, dyspnea, and quality of life in adults with stable disease. Methods: A systematic review with meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Randomized clinical trials were searched for in MEDLINE, SciELO, and the Cochrane Central Register of Controlled Trials using controlled descriptors and free-text terms. Studies published between 2016 and 2026 in Portuguese, English, or Spanish were included, involving adults undergoing inspiratory muscle training either in isolation or combined with breathing techniques. Studies lacking randomization, a control group, or extractable data were excluded. Two reviewers independently selected the studies. Outcomes, risk of bias, and certainty of evidence were evaluated. Results: Three randomized clinical trials, totaling 147 patients, met the inclusion criteria. The interventions reduced dyspnea and improved exercise tolerance, functional capacity, inspiratory muscle strength, and quality of life. A low risk of bias was observed in most domains, and the certainty of evidence was moderate. Conclusion: Inspiratory muscle training provided benefits, including a reduction in respiratory symptoms and improved quality of life. Further studies are needed to confirm these findings and expand their clinical applicability.